Touching Lives - June 2003

Rheumatoid arthritis

Rheumatoid arthritis causes the joints in the body to become inflamed, swollen and hot. The inflammation occurs in the membrane that lines the joint, the tubes that tendons move in, and the sacs of fluid that allow the muscles and tendons to move over one another.

It is predominantly a condition that affects older people but can occur in much younger people — even those in their thirties. In the UK there are around 600,000 sufferers, with women three times more likely to get it than men.

For those who have lost the ability to move their hands freely the only chance of mobility and to be free from pain is to have surgery to replace the damaged finger joints.

Reviewed operations

An Action Medical Research project at the Wrightington Hospital in Wigan has carried out a review of all the finger joint replacement operations they have performed since 1979 to see how long the new joints last. This equates to 404 operations using almost 1400 implants!

The surgeon Mr Ian Trail who led the research said: “Our results showed that even after fifteen years of use seventy per cent of the implants were still intact, which is an incredible success. This operation has a huge effect on people’s lives. ^To be able to do everyday things again is obviously a real boost for these people^.

“When deciding if finger joint replacement is the best option for the patient we look at factors such as their age, how far their fingers have drifted from their normal position, and the stage of disease.

“Other elements such as problems with the wrist have to be corrected before the fingers are replaced otherwise they lead to increased risk of fracture of the new fingers. By assessing all these factors we can make sure that the patient has the best chance of a really successful operation.

“Now that we have evaluated the operations we can see what techniques really perform well. Our findings have been reported at numerous international meetings and it is hoped that our techniques will become best practice throughout the NHS, resulting in better outcomes for patients with rheumatoid arthritis.”

Action Medical Research has a long association with the Wrightington Hospital. Professor Sir John Charnley who pioneered the first hip replacement operation worked at the hospital in the 1960s when developing his groundbreaking techniques. Action Medical Research funding allowed Professor Charnley to test and further develop an artificial hip which is still used today in thousands of operations each year.